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Lawmakers Look to Medicare Advantage Program to Test Health Care Innovation

May 11, 2018

A Congressional committee hearing focused on how the Medicare Advantage program can help improve quality and health outcomes. The program already is looking at expanded telemedicine services and improving care for patients with chronic conditions.

Medicare Advantage plans provide an opportunity for Medicare beneficiaries to receive coverage through a private insurance company. Many plans offer lower premiums, additional benefits, or reduced out-of-pocket costs.

The U.S. House Ways and Means Subcommittee on Health held the hearing. In his opening remarks Subcommittee Chairman Peter Roskam (R, IL-06) said the program can be used as a testing ground for many health care innovations that are unavailable in traditional Medicare.”

Nationwide, one in three Medicare beneficiaries is enrolled in Medicare Advantage. Forty percent (40%) of Medicare beneficiaries in Pennsylvania—more than one million Pennsylvanians—are enrolled in Medicare Advantage plans.

A representative for Independence Blue Cross, based in Philadelphia, provided testimony stating that affordability, added benefits, and greater care coordination drive the popularity of the Medicare Advantage program. She highlighted two recent policy priorities within the Medicare Advantage program and identified innovations to enhance care coordination: 

  • Expanding the availability of telemedicine services—Independence Blue Cross and Comcast recently announced a new digital health platform. The platform will be piloted in the second half of 2018, to help more patients access health care services.
  • Allowing plans to offer additional supplemental benefits and reduce cost-sharing for individuals managing chronic conditions—Independence Blue Cross will focus more resources on social determinants of health. This effort will include access to quality meals through a nutrition benefit for discharged hospital patients, and access to transportation to receive needed medical care.

Federal lawmakers value the Medicare Advantage program as a means to promote competition within the Medicare program. They point to greater flexibility within the plans to tailor benefits and services for patients.

HAP has applauded federal policy developments that expand access to telemedicine services, and provide innovative opportunities for insurers and health care providers to target the needs of individuals facing costly and complex chronic conditions. These mechanisms provide the opportunity to coordinate care in ways that will reduce health care costs and promote higher quality.

For additional information about the Medicare Advantage Program, contact Jolene Calla, Esquire, HAP’s vice president, health care finance and insurance.

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